López GM, Elizalde FF, Pinto SME, Limón AJL,  Vara FA

Language: Spanish
References: 15
Page: 102-107
PDF size: 281.41 Kb.

ABSTRACT

Introduction: Different drugs influence the duration of neuromuscular block during general anesthesia. Objective: To determine the effect of a single dose of betamethasone on the duration of rocuronium-induced neuromuscular block. Material and methods: Observational, randomized, longitudinal and prospective study. Thirty six adult patients scheduled for laparoscopic cholecystectomy received 200 µg of betamethasone intravenously one hour prior to surgery (group A), before anesthetic induction (group B) or in the postanesthesia care room with full recovery of the neuromuscular block (group C). The time course of the neuromuscular block with rocuronium (300 µg/kg) was assessed using acceleromyograpy. The main measurement was the time elapse from the start of rocuronium administration until the recovery of train of four ratio of 0.9. Results: The start of action was shorter in group B (1.3 ± 0.1 min) compared to group A (1.4 ± 0.4 min) and C (1.6 ± 0.9 min). The recovery index 25-75% was lower in group B (14 ± 7.8 min) compared to group A (15.0 ± 11.1 min) and C (15.2 ± 11.1 min). Conclusion: The time of rocuronium induced block decreases approximately 5% before the administration of a single dose of betamethasone during induction of anesthesia.

REFERENCES

1. Serra H, Roganovich JM, Rizzo LF. Glucocorticoides: paradigma de medicina traslacional de lo molecular al uso clínico. Medicina. 2012; 72 (2): 158-170.

2. Pascuzzo C. Glucocorticoides. En: Farmacología básica, Ed. El depósito de Ley; 2008, p. 855-865.

3. Martínez H, Montenegro P, Restrepo JF, Rondón F, Quintana G, Iglesias A. Historia de los glucocorticoides. Rev Colomb Reumatol. 2010; 17 (3): 147-171.

4. Soltész S, Fraisi P, Noé KG, Hinkelbein J, Mellinghoff H, Mencke T. Dexamethasone decreases the duration of Rocuronium-induced neuromuscular block: a randomised controlled study. Eur J Anaesthesiol. 2014; 31: 417-422.

5. Grover VK, Babu R, Bedi SPS. Steroid therapy-current indications in practice. Indian Journal of Anaesthesia. 2007; 51 (5): 389-393.

6. Gan TJ, Diemunsch P, Habib AS, Kovac A, Kranke P, Meyer TA et al. Consensus guidelines for the management of posoperative nausea and vomiting. Anesth Analg. 2014; 118: 85-113.

7. Apfel CC, Jeindrich FM, Jukar-Rao S. Evidence-based analysis of risk factors for posoperative nausea and vomiting. Br J Anaesth. 2012; 109: 742-753.

8. De Oliveira GS, Almeida MD, Benzon HT, McCarthy RJ. Perioperative single dose systemic dexamethasone for postoperative pain: a meta-analysis of randomized controlled trials. Anesthesiology. 2011; 115: 575-588.

9. De Oliveira GS Jr, Castro-Alves LJ, Ahmad S, Kendall MC, McCarthy RJ. Dexamethasone to prevent postoperative nausea and vomiting: an updated meta-analysis of randomized controlled trials. Anesth Analg. 2013; 116: 58-74.

10. Aasboe V, Raeder JC, Groegaard B. Bethamethasone reduces postoperative pain and nausea after ambulatory surgery. Anesth Analg. 1998; 87: 319-323.

11. Soltesz S, Mencke T, Stunz M, Diefenbach C, Ziegeler S, Molter GP. Attenuation of a rocuronium-induced neuromuscular block in patients receiving prednisolone. Acta Anaesthesiol Scand. 2009; 53: 443-448.

12. Soltesz S, Mencke T, Mey C, Röhrig S, Diefenbach C, Molter GP. Influence of a continuous prednisolone medication on the time course of neuromuscular block of atracurium in patients with chronic inflammatory bowel disease. Br J Anaesth. 2008; 100: 798-802.

13. Parr SM, Robinson BJ, Rees D, Galletly DC. Interaction between betamethasone and vecuronium. Br J Anaesth. 1991; 67: 447-451.

14. Kindler CH, Verotta D, Gray AT, Gropper MA, Yost CS. Additive inhibition of nicotinic acetylcholine receptors by corticosteroids and the neuromuscular blocking drug vecuronium. Anesthesiology. 2000; 92: 821-832.

15. Haberer JP. Farmacología de los curares. EMC, Anesthésic Réanimation. 2017; 36-355-A-10.